Mohnarin 2009年度报告:青壮年(14-65岁)来源菌株耐药监测

Mohnarin 2009 annual report:Bacterial resistance surveillance in patients between 14 and 65 years old

目的了解我国青壮年(14-65岁)感染患者病原菌构成及其耐药情况。方法收集114家成员单位2009年度抗菌药物敏感试验数据,根据Mohnarin的监测方案和CLSI2009年标准,用WHONET软件(5.5版本)对青壮年(14-65岁)患者的耐药监测数据进行分析总结。结果 2009年度全国114家Mohnarin成员单位,临床分离菌青壮年人群来源的菌株共82115株。其中,革兰阴性菌占70.04%,主要菌株依次为大肠埃希菌14696株(17.90%)、肺炎克雷伯菌8517株(10.37%)、铜绿假单胞菌7903株(9.62%)及鲍曼不动杆菌7309株(8.90%);革兰阳性菌占29.96%,主要菌株依次为金黄色葡萄球菌7550株(9.19%)、表皮葡萄球菌4068株(4.95%)、粪肠球菌3099株(3.77%)和屎肠球菌2590株(3.15%)。对葡萄球菌属保持100%敏感的有利奈唑胺、万古霉素;出现替考拉宁耐药的葡萄球菌约0.8%和万古霉素耐药的屎肠球菌为2.6%;肠杆菌科细菌中,大肠埃希菌、肺炎克雷伯菌和奇异变形杆菌的ESBL检出率分别为62.1%,42.4%和27.5%;所有上报的肠杆菌科细菌,均开始出现碳青霉烯类耐药菌株;非发酵菌对各类抗菌药物的敏感性均很低,保持70%敏感率的药物主要有多粘菌素B和碳青霉烯类;但不动杆菌对碳青霉烯类的敏感性已下降到50%左右;苛氧菌在青壮年人群感染标本中的分离率仍很低,但对各类抗菌药物保持很高的敏感性。结论我国青壮年人群感染病原菌以革兰阴性菌为主,所有细菌对常用抗菌药物的耐药性严重。

Objective To understand pathogenic bacteria distribution and drug resistance of the bacteria isolated from Chinese young and mid-aged patients（14-65 years）.Methods All antimicrobial susceptibility test data of 114 member hospitals from 1 Jan.to 31 Dec.in the year 2009 were collected according to the Mohnarin surveillance program and CLSI 2009 rules.All the data came from young and mid-aged patients（14-65 years） were analyzed by WHONET 5.5 software.Results A total data of 208208 isolates were submitted by 114 member hospitals in the year 2009.Isolates of 82115（39.44%） were from young and mid-aged adults.Gram-negative bacteria accounted for 70.04%,of which E.coli 14696（17.90%）,Klebsiella pneumoniae 8517（10.37%）,Pseudomonas aeruginosa 7903（9.62%） and Acinetobacter baumannii 7309（8.90%）.Gram-positive bacteria accounted for 29.96%,including Staphylococcus aureus 7550（9.19%）,Staphylococcus epidermidis 4068（4.95%）,Enterococcus faecalis 3099（3.77%） and Enterococcus faecium 2590（3.15%）.With gram-positive bacteria,drug susceptibility data showed that linezolid and vancomycin was still 100% sensitive to Staphylococci,most important is teicoplanin-resistant Staphylococcus aureus（0.8%） and vancomycin-resistant Enterococcus faecium（2.6%） were emergented.With gram-negative isolates,ESBLs producing Escherichia coli,Klebsiella pneumoniae and Proteus mirabilis were 62.1%,42.4% and 27.5% respectively.To be worth mentioned is a few bacteria of Enterobacteriaceae has gotton resistance to carbopenems.Non-fermenting bacteria still keep high resistant to various antimicrobial agents except polymyxin B,polymyxin C and carbopenems,for which they all keep more than 70% sensitivity excluding Acinetobacter baumannii with less than 50% sensitivity to carbopenem.Most of fastidious bacteria keep high sensitivity to kinds of antibiotics but seldom isolated from young and mid-aged patients.Conclusion Strains isolated from Chinese young and mid-aged patients were mainly gram negative bacteria,which became more resistant to antimicrobial agents than ever.Strengthen surveillance of bacterial resistance and promote the rational use of antibiotics is very important.